Dear Friends:
    The latest horror  is the article from Obstet Gynecol (2001;
97:911-915),  to which Jan refers,  that says "labor induction per se does
not increase the risk of c/s, it is because the women are nulliparous or have
undilated cervixes prior to labor or have epidural anesthesia".
    "Honest folks, it's not us obstetricians doing the inductions that are
the problem, it's these damn women and their faulty bodies! "  Even though
the c/s rate in the induction group for failure to progress was 14% in the
induction group and was 8% in the spontaneous labor group, logistic
regression analysis showed that it's the women's bodies that are at defective.
    Is that what obstetricians do? Regress logically?
    In 1998, the national (USA)  induction rate was nearly 20%; the national
augmentation rate was 17.8%. You mean that 40% of women can't labor without
hormonal stimulation? (Wish we had something like that for orgasm!) We are
seeing what happens when women are pumped full of fluid so that pitocin can
be used, there are more breastfeeding problems. Folks, please publish these
findings! A letter to the editor is far easier to publish than an article.
    It would be helpful to have an accurate definition for birth, as we now
have, thanks to Labbok and Krasovec, more precise definitions of
breastfeeding. At present, all vaginal birth is considered equivalent, and
traumatic, leading to the trend towards elective cesarean section.
    So, is birth spontaneous or induced? Medicated or unmedicated? Unassisted
or operative? At home or in the hospital? I don't think the exit portal from
the body is what defines birth any more, do you?
    Yes, we will need an LC for every dyad in a few years.
    Warmly,
Nikki Lee RN, MSN, Mother of 2, IBCLC, CIMI
craniosacral therapy practitioner; childbirth educator
Elkins Park (a suburb of Philadelphia, Pennsylvania; northeastern USA)
supporting the WHO Code and the Mother Friendly Childbirth Initiative

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